Reimbursement Specialist

Valeris

. Provide in-depth knowledge of client programs by working with patients, healthcare providers, and insurance companies .

Posted 9/15/2026full-timeUnited StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in patient benefits verification, eligibility determination, and prior authorization processes while providing exceptional customer service in a healthcare setting. Proficient in using PharmaCord Lynk for claims processing and maintaining workflows, with a strong focus on patient access and support.

Highest-signal resume keywords

Patient Benefits VerificationPrior Authorization CoordinationPharmaCord LynkCustomer Service ExperienceHealthcare Industry Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Benefits Coverage AssessmentEligibility DeterminationClaims ProcessingTyping Speed of 35 Words Per MinutePatient Assistance Enrollment Review

Soft Skills

Emotional IntelligenceClear Communication SkillsAttention to DetailService-Minded AttitudeProfessionalism

Certifications & Qualifications

Healthcare-Related Certification

Industry Keywords

HealthcarePatient AccessInsurance CompaniesSOPsConfidentiality

About the role

Key responsibilities & impact

Provide in-depth knowledge of client programs by working with patients, healthcare providers, and insurance companies
Answer inquiries and process service requests
Assess benefits coverage and manage barriers to patient access to therapy
Provide telephonic and web-based customer service support
Perform patient-level benefits verifications for major medical and pharmacy benefit plans
Complete patient-level benefits Coverage Determination Summary forms
Coordinate prior authorizations according to payer guidelines and applicable law, regulation, or guidance
Review patient assistance enrollment forms and supporting documentation
Determine patient eligibility according to program criteria
Communicate eligibility decisions to patients, healthcare providers, and consignment pharmacies
Answer inbound callers and resolve inquiries or warm-transfer callers
Listen to customers, assess needs, and respond with patience and courtesy
Identify missing or incorrect information in service requests and applications
Report adverse events and product complaint inquiries according to SOPs and good manufacturer practices
Provide feedback regarding service failures and customer concerns
Use PharmaCord Lynk to process claims and maintain workflows
Communicate with medical practice accounts and sales representatives regarding case status
Provide consultative services to overcome obstacles and transition patients to paid therapy
Follow company values, policies, SOPs, and training deadlines
Perform additional assigned tasks or projects

Requirements

What you’ll need

Bachelor's degree strongly preferred or equivalent experience required
High school diploma or GED required
6 months customer service experience, payer benefits experience, healthcare industry experience, healthcare-related certification, license, or equivalent coursework strongly preferred
Service-minded, focused on recognizing and meeting the needs of patients and care partners
Ability to handle personal health information confidentially
Honesty and integrity
Professionalism and strong business and customer service etiquette
Clear verbal and written communication skills
Accountability for results
Ability to plan and prioritize tasks with strong attention to detail
Emotional intelligence
Ability to manage disruptive impulses and stressful customer interactions
Proficient computer skills
Adaptability to change
Initiative and commitment to team and organizational goals
Ability to work effectively within a team
Positive attitude
Bilingual is a plus
Ability to sit for extended periods
Preferred typing speed of at least 35 words per minute with 97% accuracy
Minimal flexibility to travel as needed preferred
Successful completion of a background check and, depending on position, a drug screen

Benefits

Comp & perks

Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
Telehealth and Employee Assistance Program (EAP) services
Company match on Health Savings Account contributions
Free Basic Life and AD&D coverage equal to annual earnings, with a minimum of $50,000 and a maximum of $300,000
Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
401(k) Retirement Savings Plan with 100% match on the first 5% contributed, with immediate vesting
Paid Time Off (PTO) and Sick Leave
Nine paid holidays plus two floating holidays
Opportunities for advancement and personal and professional growth
Challenging, stimulating work environment encouraging new ideas
Inclusive workplace and mission-driven culture
Full-time employment